Active NPI
Susan L Mancone, PT
- Physical Therapist
- Lake Worth, FL
National Provider Identifier
1316279342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 2095
- Practice address
- 6749 Las Colinas St
Lake Worth, FL 33463-6566 - Phone
- (561) 964-1020
- Fax
- (561) 641-4455
- NPI assigned
- Feb 1, 2010
- Last updated
- Feb 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 2095 | FL | Primary |
Addresses
Primary practice location
6749 Las Colinas St
Lake Worth, FL 33463-6566
Mailing address
478 Foresta Ter
West Palm Beach, FL 33415-2614
Phone (561) 682-3888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 2095 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264982400000",
"number": "1316279342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "478 FORESTA TER",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334152614",
"telephone_number": "561-682-3888",
"fax_number": "561-682-3888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6749 LAS COLINAS ST",
"city": "LAKE WORTH",
"state": "FL",
"postal_code": "334636566",
"telephone_number": "561-964-1020",
"fax_number": "561-641-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCONE",
"first_name": "SUSAN",
"middle_name": "L",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-01",
"last_updated": "2010-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 2095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Worth, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.